Tennis Elbow

Tennis elbow is a condition of inflammation around the bony knob on the outer side of your elbow. It occurs when the tissue that attaches muscle to bone becomes irritated. The bony prominence is called the lateral epicondyle, and therefore tennis elbow is also known as lateral epicondylitis. Interestingly, most of our patients are not tennis players. A similar condition of tendonitis occurs on the inner aspect of the elbow, and this is known as medial epicondylitis, or golfer’s elbow. Again, most of our patients with this condition are not golfers. While playing a racquet sport can cause tennis elbow, so can performing any activity that involves extending your wrist or rotating your forearm.

While the exact cause is unknown, certain activities and types of employment can substantially contribute to the development of this condition. The most common symptom of tennis elbow is pain on the outer side of the elbow and down the forearm. You may have pain all the time, or only when you lift things. The elbow may also swell, become red, or feel warm to touch. It may hurt to grip items, turn your hand, or swing your arm. You may have pain radiating down the forearm, or pain while extending your wrist. The muscles that allow you to straighten your fingers and rotate your arm and wrist are called the extensor muscles. These muscles extend from the outer side of your elbow to your wrist and fingers. A cord-like fiber called a tendon attaches the extensor muscles to the elbow. Overuse or an accident can cause tissue in the tendon to become inflamed or injured. When the tendon is inflamed, the nerves around the tendon become irritated. Then moving your elbow is painful. The diagnosis of tennis elbow is made by your history and physical exam.

Treatment involves wrist splinting, rest, and alteration of activities and employment. Sometimes a complete change of employment is necessary. Treatment also involves anti-inflammatory medications and supervised occupational therapy. We have a certified occupational therapist directly on site in our office. When rest, occupational therapy, and cortisone injections have failed to relieve your symptoms, then surgery is indicated.

We usually do not recommend surgery for symptoms that have been present for less than one year. Several different techniques are commonly performed for the treatment of tennis elbow, but all involve surgery in the operating room under general anesthesia, as an outpatient, and all involve a debridement or cleaning out, of the inflamed tendon area. Occupational therapy is mandatory following surgery to ensure a positive outcome. Following surgery, light duty may be resumed in 6-8 weeks, but the depending upon the demands of your activities or employment, full duty may not be possible for several months. Indeed, a return to your initial job may even be impossible, depending upon what type of work you perform. Complications include scarring, stiffness, and persistent pain.